Individual
MRS. JENNIFER HUWALDT HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8435 SE 68TH ST STE 118, MERCER ISLAND, WA 98040
(206) 232-7546
Mailing address
3745 88TH AVE SE, MERCER ISLAND, WA 98040-3616
(361) 549-3882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17079
IN
363AM0700X
Medical Physician Assistant
Primary
PA-60617414
WA
363AM0700X
Medical Physician Assistant
PA9103781
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA-60617414
WASHINGTON LICENSE
WA
01
—
PA17079
LICENSE #
CA
01
—
PA9103781
PA STATE LICENCE
FL
Enumeration date
10/12/2005
Last updated
10/23/2019
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